History of Hysterectomy: A Significant Problem for Colonoscopists That Is Not Present in Patients Who Have Had Sigmoid Colectomy

Abstract

Posthysterectomy adhesions to the sigmoid colon make colonoscopy more difficult and more painful. These adverse effects are not present in hysterectomized women who have undergone sigmoid resection.

Colonoscopy reduced distal colorectal cancer risk and excess cancer risk associated with family history

“…Limitations of our study include it being restricted to women; however, investigating the efficacy of colonoscopy for proximal cancers in women is particularly relevant since proximal cancers are more frequent in women than in men [32], and tumors may be technically more difficult to diagnose in women because of pelvic adhesions [23]. Still, results similar to ours have been obtained in male populations [16].…”

“…Several hypotheses have been proposed to explain the observed differences in colonoscopy efficacy between the distal and proximal colon. These include lesser quality of colon cleansing in the proximal than in the distal colon, and the importance of trained and experienced endoscopists; indeed, the proximal colon may be difficult to reach and explore properly, especially in women [23]. In addition, proximal adenomas are often flat, and difficult to identify and remove [24], even by an experienced endoscopist.…”

The Effect of Hysterectomy on Colonoscopy Completion

“…eighteen full-text articles were assessed for eligibility, 12 of which were excluded ( fig. 3,14 five studies described methods of proof of completion and defined completion of colonoscopy as depiction of the ileocecal valve and the appendix orifice, 4,7,14,15 or confirmed with fluoroscopy. four studies included a statement on the qualifications of those performing colonoscopy.…”

“…1). 3,4,7,14,15 two studies used polyethylene glycol solutions for bowel cleansing. 3,4,13,14 only 1 study gave an exact definition of the length of experience of the endoscopist (>10 years).…”

“…3,4,7,[13][14][15] Cecal intubation was achieved in 87.1% of patients with a history of hysterectomy compared with 95.5% of women with no history of pelvic surgery. 3,4,7,[13][14][15] Cecal intubation was achieved in 87.1% of patients with a history of hysterectomy compared with 95.5% of women with no history of pelvic surgery.…”